Pay for Performance – what do you think?
www.ama-assn.org/amednews/2011/10/24/bisf1027.htm
Here it comes…pay-for-performance sounds like a good concept but runs into problems with definitions and ultimately, who sets them. Patient satisfaction is about as vague a measure as possible and creates, like all incentives, unintended consequences when health systems try to comply. Outcomes? Is it reasonable to force our health systems to take responsibility for our lifestyle choices? In other parts of the economy, the market makes the choice – those that provide value are rewarded with survival and those that don’t provide value don’t last. Healthcare has many nuances but it it seems counter-productive to try to legislate quality with financial incentives when consumers are more than capable of making the choices themselves. Government or insurance, the result is nearly the same; someone else is choosing how to motivate or punish our care giver. Should we be working harder to open up competition or continuing to let payors shrink our options?